Atherosclerosis (As) poses a serious threat to human health, and modern medicine still faces many limitations in its treatment of this disease. However, components and compounds of traditional Chinese medicine (TCM) have unique advantages in anti-atherosclerosis by regulating macrophage autophagy, they exert anti-inflammatory, anti-oxidation, lipid metabolism-regulating and plaque-stabilizing effects. This paper reviews the application of TCM in regulating macrophage autophagy to prevent and treat atherosclerosis, and provides new insights into the application of TCM components and compounds in the treatment of As.